Is Wisdom Tooth Removal Necessary?

Should you have your wisdom teeth removed? It depends on a lot of different factors. Healthy teeth are often fine. On the other hand, when these teeth erupt improperly it can cause malocclusion, a sometimes severe dental problem where the upper and lower jaw don’t align properly. Apart from ruining your smile, this can often cause long-term mouth and dental issues.

Why Do Wisdom Teeth Create Problems?

Wisdom teeth, also called “third molars”, typically erupt in early adulthood—from age 18 through the late 20s. In most cases, these teeth emerge in a healthy manner and don’t disrupt the rest of the teeth or jaw structure. However, in 30% of cases, their emergence may cause problems. These problems can occur for several reasons:

  • Your third molars only emerge partway, leaving a flap of gum covering them. This makes them difficult to clean and can lead to infection. This problem is normally caused by teeth trying to emerge without adequate space.
  • Your wisdom teeth come in so far back that cleaning is difficult, leading to risks of infection
  • Your wisdom teeth are impacted, or only emerge partway due to a lack of space. This can throw off your smile and cause problems later on.
  • Your wisdom teeth come in crooked.

Most of the problems related to wisdom teeth come in the form of infection. See the image below for an example.

wisdom teeth infection

Preventing Problems

Periocoronitis, or an infection near the wisdom teeth, is the most common issue. It’s typically caused by a wisdom tooth that doesn’t have enough space to emerge, and so only emerges partway. This can lead to a flap of the gums remaining on top of the tooth, which allows infection to set in.

The most common treatment is good oral hygiene. Your dentist will often clean the area as well, and if an infection sets in may proscribe oral antibiotics. However, if this is not enough, your dentist may remove the gum flap itself or even the wisdom tooth.

If you’re having dental issues, it’s important to see your dentist as soon as possible. These problems can fester and become worse if left untreated.

Is Extraction Necessary?

There are costs and benefits associated with pulling out your wisdom teeth, and the net effect will depend on your individual issue.

Removal is fairly common for young adults, but a recent study suggested that 60% of these removals—resulting in procedures for 3 million people per year—aren’t necessary.

Apart from the cost and discomfort of surgery, there are occasional dangers associated with extraction. Paresthesia, which refers to the numbness of the cheek, lip, and tongue caused by nerve damage, is an uncommon side effect of surgery. Between 0.4% and about 8.4% of patients experience this condition. While the odds are low, it may dissuade some people from having their third molars removed. However, tooth removal can also be an important part of oral health. If your wisdom teeth are damaging other teeth, swelling your gums, or affecting your jawline, than removal is often essential. There are also cases wherein a cyst (fluid-filled sac) may grow around the tooth. This may damage the surrounding bone and tissue. If you’re experiencing pain or bleeding in the back of your mouth, this may point to problems with how your back teeth come in.

Many dentists will also remove third molars based on X-rays that show that they’re fine now but may cause problems in the future. As people age, their jaws become more rigid, which makes removal more difficult. Because of this, your dentist may recommend you remove your wisdom teeth now rather than waiting until they become a problem.

If your dentist does recommend wisdom teeth removal, you don’t always have to act right away. You may have several months to weigh the pros and cons. However, if your wisdom teeth are truly causing problems, it’s best to remove them as soon as possible.

Written by Frank Versteeg, an outreach specialist with Sonrisa Family Dental.